Is Demography Destiny?

Most Americans know that the U. S. population is aging. They have heard about the U. S. Census Bureau's projection that the elderly population will more than double by 2040, and dire predictions about the future of Medicare and the Social Security system. What they have heard less about is the other factors that will affect the future of these programs and the challenges inherent in the aging of society.

A new report, Demography Is Not Destiny, January 1999, from the National Academy on an Aging Society, uses data from a variety of sources to examine past and anticipated trends. The report presents compelling evidence to illustrate that while the aging of society poses a significant challenge, this challenge can be met with a reasoned set of policy devices. In a nutshell, economic growth, changes in individual behavior, and public policies are key factors that will determine how the aging society will affect future government spending, and the income and health security of future generations of elderly and their families. This report yields the following major messages:

Population projections are fraught with uncertainty. The Census Bureau, for example, has made a whole range of projections about the size of the U. S. population in 2040, the lowest and highest of which differ by 170 million people.

Projections are, by definition, based on assumptions. They are conditional statements about what will happen, if and only if certain other things happen. As more information becomes available, the range of uncertainty narrows.

The elderly population has already grown dramatically, both in size and as a proportion of the population, without devastating consequences. There are more than twice as many elderly today as in 1960. But the nation's real national income has more than tripled during the same period, making us better off even though we have aged as a population.

It is easier to make statements about the future based only on demographic predictions than on all the interactions among people, communities, and institutions. But, demography is not destiny. Other factors that also alter the course of the future include economic growth, changes in people's expectations and behavior, and changes in public policies.

Today is different from the past. The elderly of today are healthier, wealthier, and better educated on average than the elderly of any previous generation. This does not mean that all the elderly are doing well, however. Substantial inequality exists within the elderly population, with some groups among the elderly particularly vulnerable. If these disparities continue-or, worse still, grow-the future well-being of America's elderly population generally could be threatened.

Future Viewpoint articles will explore the messages of this report in detail. If you have questions, or would like to see or order a copy of the report, please contact Michael Stogner at the ACOG's office.

(Parts excerpted from Demography is Not Destiny.)